Why Breast Cancer Kills More Black Women

Why Breast Cancer Kills More Black Women

Randolph, Laura B., Ebony

Alarming statistics spark national search for answers

Teresa Ross was 44 when she learned she had breast cancer. "When my doctor told me," recalls the Washington, D.C., mother, "I lost complete control of myself. I didn't just cry; I became hysterical. Part of it was fear and part of it was shock. I'd never given breast cancer a second thought."

Like the majority of Black women her age, until Ross was diagnosed with the disease three years ago, she had never had a mammogram, a low-dose X-ray of the breast that accurately diagnoses 90% of breast cancers.

"The only reason I had the mammogram is because my doctor insisted," says Ross, a program analyst for the federal government who underwent a lumpectomy followed by radiation therapy and is now cancer free. "It was a real wake-up call. Now, I tell everyone how important early detection is."

Crucial would be more accurate. As any doctor will tell you, early detection saves the lives of most patients. According to the National Cancer Institute (NCI), the five-year survival rate for women whose tumors haven't spread beyond the breast is a whopping 92%. Even if the cancer has spread to the axillary (underarm) lymph nodes, the five-year survival rate is still high - 71%. It drops to 19% however, if the cancer has spread to distant sites in the body like the liver, brain or lungs.

For Black women, these statistics have life and death significance. Literally. For one thing, breast cancer is the leading cause of cancer death for African-American women. For another, Black women develop the disease at a younger age than White women. And, though White women are more likely than Black women to get breast cancer, Black women are more likely to die from it. (Since 1974, the NCI says, breast cancer deaths among Blacks have increased 13%, though they have decreased 11% among Whites.)

What's behind these chilling statistics? Why do more Whites survive the disease than Black? Why are Black women now considered at greatest risk for death from breast cancer and why do more of us die of this disease than any other race? How do we explain why breast cancer deaths among Black women are rising when they are falling among White women?

While several recent studies suggest that breast cancer might appear in a more deadly form among Black women, doctors and patients agree that the major reason was summed up by Morehouse Medical School President Dr. Louis Sullivan while he was was secretary of Health and Human Services.

"Minority women," said Sullivan, "particularly Black women, do not have sufficient access to breast cancer information or screening facilities."

Zora Kramer Brown, 44, a breast cancer survivor who discovered her cancer in 1981 through a routine self-exam, agrees. But, says Brown, the disparity isn't solely the result of lack of early detection and early care.

"We don't have enough clinical trial research on African-American women to understand the biology of the disease as it affects us," says Brown, who founded and chairs the Breast Cancer Resource Committee, a non-profit Washington, D.C., organization dedicated to cutting in half the number of African-Americans who die from breast cancer by the year 2000.

What we do know, however, "is that we get breast cancer at an earlier age and we're diagnosed with it at a later stage," says Brown, whose great grandmother, grandmother, mother and three sisters were all diagnosed with the disease.

If, as Brown and many other contend, the medical profession's understanding of breast cancer in Black women is in its early stages, how are they supposed to determine, let alone lower, their risk of developing it?

With a cure for breast cancer in the near future unforeseen, experts agree there is only one answer: "Black women must educate themselves with the vast amount of information that is available," says Dr. Edwin T. Johnson, a board certified general surgeon and director of the Montgomery Urgent Care and Diagnostic Center in Montgomery, Ala. …

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